Cost-effectiveness of surgery for degenerative cervical myelopathy in the United Kingdom.

Purpose: Degenerative cervical myelopathy (DCM) is the commonest cause of adult spinal cord dysfunction worldwide, for which surgery is the mainstay of treatment. At present, there is limited literature on the costs associated with the surgical management of DCM, and none from the United Kingdom (UK). This study aimed to evaluate the cost-effectiveness of DCM surgery within the National Health Service, UK.

Anterolateral versus posterior minimally invasive lumbar interbody fusion surgery for spondylolisthesis: comparison of outcomes from a global, multicenter study at 12-months follow-up.

Background Context: Several minimally invasive lumbar interbody fusion techniques may be used as a treatment for spondylolisthesis to alleviate back and leg pain, improve function and provide stability to the spine. Surgeons may choose an anterolateral or posterior approach for the surgery however, there remains a lack of real-world evidence from comparative, prospective studies on effectiveness and safety with relatively large, geographically diverse samples and involving multiple surgical approaches.

Purpose: To test the hypothesis that anterolateral and posterior minimally invasive approaches are equally effective in treating patients with spondylolisthesis affecting one or two segments at 3-months follow-up and to report and compare patient reported outcomes and safety profiles between patients at 12-months post-surgery.

Lumbar Fixation Using the Cortical Bone Trajectory Fixation: A Single Surgeon's Experience With 3-Year Follow-up.

Background: Pedicle screw fixation with a cortical bone trajectory (CBT) has emerged as an effective alternative to traditional techniques of lumbar fusion, especially in osteoporotic patients. The proposed benefits of CBT screws include a stronger grip in the elderly and osteoporotic population and low surgical morbidity. We present a prospective study with a 3-yr follow-up of 80 patients operated on by the same surgeon.

The oldest presenting neurenteric cyst of the spinal cord.

We describe an 81-year-old gentleman presenting with mild myelopathic symptoms in the upper limbs. Imaging showed a C1-3 intradural extramedullary lesion initially thought to be an arachnoid cyst. A C1 + 2 hemilaminectomy and partial excision was performed with histology revealing a neurenteric cyst (NC).

Does proximity to the subventricular zone and expression of CXCR-4 and nestin affect prognosis in high-grade glioma?

Background: It is suspected that infiltration of stem cell areas with high-grade glioma (HGG) generates a population that compromises treatment results and survival. In this prospective study we set to assess the prognostic value of the proximity of the contrast-enhancing lesion (CEL) on MRI to the subventricular zone (SVZ) and the expression of CXCR4 and nestin as potential factors in the stem cell migration pathway.

Method: All patients diagnosed with high-grade glioma over a three-year period from a single institution were enrolled in this prospective study.

Concomitant idiopathic hypertrophic spinal pachymeningitis and Guillain-Barré syndrome in a patient: coincidence or a triggering mechanism?

Idiopathic hypertrophic spinal pachymeningitis (IHSP), a rare diffuse inflammatory thickening of the dura mater, and Guillain-Barré syndrome (GBS) are known entities but they have never been reported as concomitant diagnoses. To their knowledge, the authors present the first reported case in the international literature with supportive evidence for both IHSP (based on MRI, intraoperative, and histological findings) and GBS (based on history, clinical examination, and electrophysiological findings). They review the literature on IHSP and the diagnostic criteria for GBS, with the view of identifying a possible causative connection.

Clinical outcomes during the learning curve of MIDline Lumbar Fusion (MIDLF®) using the cortical bone trajectory.

Objective: The objective of this study is to review the clinical outcomes of a novel minimally invasive surgery (MIS) technique for the treatment of instability of the lumbar spine using the cortical bone trajectory (CBT). We present a prospective review of the clinical outcomes from the first 25 consecutive cases in a single unit during the initial learning phase.

Materials And Methods: The investigation group included the first 25 patients (eight males and 17 females) who underwent MIDLF® since the introduction of this technique in a single unit.

Utility of routine biopsy at vertebroplasty in the management of vertebral compression fractures: a tertiary center experience.

Object: The authors assess the utility of routine biopsy at vertebroplasty for vertebral compression fracture (VCF) as a tool in the early detection of malignancy in presumed benign VCF.

Methods: A prospective observational study was conducted on a cohort of consecutive patients undergoing vertebroplasty over a 5-year period between April 2006 and March 2011 at the Royal London Hospital. Polymethylmethacrylate cement injection was used in every procedure.

Abscess of the medulla oblongata in a toddler: case report and technical considerations based on magnetic resonance imaging tractography.

Background And Importance: We report a unique case of a toddler (the only one reported) successfully operated on for a medulla oblongata abscess and comment on the influence of neuroimaging modalities in the preoperative planning of the surgical approach.

Clinical Presentation: We report a case of a 20-month-old child with a solitary medulla oblongata abscess. The abscess appeared to be in close proximity to the anterior medulla oblongata, but preoperative planning based on diffusion tensor imaging (DTI) tractography motivated us to try to remove this lesion through a midline suboccipital approach.

Development and validation of a direct headspace GC-FID method for the determination of sevoflurane, desflurane and other volatile compounds of forensic interest in biological fluids: application on clinical and post-mortem samples.

A simple and reliable headspace GC-flame ionization detection (HS-GC-FID) method has been developed and validated for the simultaneous determination of seven volatile compounds of forensic interest: sevoflurane, desflurane, ethanol, methanol, 1-propanol, acetone and acetaldehyde. All seven compounds including acetonitrile (internal standard) eluted within 10 min and were well resolved with no endogenous interference. Good linearity was observed in the range of 1-12 mg/dL for both anesthetics and 2.

Material-specific difficulties in episodic memory tasks in mild traumatic brain injury.

The study examines acute, material-specific secondary memory performance in 26 patients with mild traumatic brain injury (MTBI) and 26 healthy controls, matched on demographic variables and indexes of crystallized intelligence. Neuropsychological tests were used to evaluate primary and secondary memory, executive functions, and verbal fluency. Participants were also tested on episodic memory tasks involving words, pseudowords, pictures of common objects, and abstract kaleidoscopic images.